Department of Public Health

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Browsing Department of Public Health by Author "David, Mukunya"

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    Factors associated with retention of motherbaby pairs in the elimination of mother-tochild transmission of HIV program in Kaberamaido district: A longitudinal analysis
    (PLOS One Publishers, 2023-07-21) James Daniel, Odongo; Ronald, Opito; Benon, Wanume; Denis, Bwayo; David, Mukunya; Samuel, Okware; Joseph K. B., Matovu
    Abstract Background Retention along the elimination of Mother to Child Transmission (eMTCT) cascade in Uganda remains poor as only 62.7%-69.5% are followed up to 18months. The objective of this study was to determine the rates of retention of mother-baby pairs at two levels of the eMTCT cascade (12 and 18 months) and associated factors. Methods This was a longitudinal analysis of 368 mother-baby pairs who were enrolled into the eMTCT program in Kaberamaido district from January 2013 to December 2018. Data was extracted from early infant diagnosis (EID) and mothers’ ART registers, entered into Microsoft Excel and then exported to Stata statistical software package version 14.0 for management and analysis. Descriptive statistics such as mean and frequencies were computed at univariate level. At the bivariate level, Cox proportional hazard regression was performed to assess the level of association between the primary outcome and each independent variable, while Cox proportional hazard regression model was built at multivariate level to determine the factors independently associated with retention of mother-baby pairs in the eMTCT program. Results Of the 368 mothers enrolled into the study, their average age was 29.7years (SD = 6.6). Nearly two-thirds of the mothers were married/cohabiting, (n = 232, 63.0%). The 368 mother baby pairs were observed for a total time of 6340 person months, with majority, 349 (94.8%, 95%CI = 92.0–96.7) still active in eMTCT care, while 19(5.2%, 95%CI = 3.3–8.0) were lost to follow up at 12months. At 18 months, 323 (87.8%, 95%CI = 84.0–90.8) were active in eMTCT program while 45(12.2%, 95 CI = 9.2–16.0) were lost to follow up. At bivariate level, marital status, health facility level of enrolment, mothers’ ART treatment supporter, and mothers’ ART enrolment time were significantly associated with survival/lost to follow up (LTFU) of mother-baby pairs along the eMTCT cascade. At multivariable level, the mothers’ time of ART initiation was significantly associated with survival/lost to follow up (LTFU) of mother-baby pairs at along the eMTCT cascade, with mothers-baby pairs who were initiated during the antenatal/post-natal periods having higher hazards of LTFU compared to those who initiated ART before Antenatal period (before pregnancy), aHR = 4.37(95%CI, 1.62– 11.76, P = 0.003). Mother-baby pairs who were enrolled into the eMTCT program after the implementation of HIV test and treat policy (year 2017 and 2018) had higher hazards of LTFU as compared to those enrolled before the implementation of test and treat policy in Uganda (year 2013–2016), aHR = 2.22(95% CI, 1.15–4.30, P = 0.017). All the other factors had no significant association with lost to follow up and cascade completion at multivariate level. Conclusion There was high level of retention of mother-baby pairs in the eMTCT program in Kaberamaido at 12 months, but it was suboptimal at 18months. ART initiation during the antenatal and/or post-natal period was significantly associated with suboptimal retention of motherbaby pairs along the eMTCT cascade.
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    Uptake of prostate cancer screening and associated factors among men aged 50 years and above in Lira city, Uganda: a crosssectional study
    (BMC Public Health, 2023-03-06) Richard, Ekwan; Emmanuel, Bua; Ritah, Nantale; Ronald, Opito; Patrick, Abingwa; Quraish, Sserwanja; Job, Kuteesa; David, Mukunya
    Abstract Background Prostate cancer is the most common cancer among men globally, with over 1.2 million cases reported in 2018. About 90% of men with prostate cancer are diagnosed when the disease is in an advanced stage. We assessed the factors associated with the uptake of prostate cancer screening among men aged ≥ 50 years in Lira city. Methods This was a cross-sectional study involving 400 men aged ≥ 50 years in Lira city who were sampled using multistage cluster sampling method. Uptake of prostate cancer screening was defined as the proportion of men who received prostate cancer screening in the past one year prior to the interview. Multivariable logistic regression analyses were performed to assess the factors associated with the uptake of prostate cancer screening. Data were analyzed using Stata version 14.0 statistical software. Results Of the 400 participants, only 18.5% (74/400) had ever been screened for prostate cancer. However, 70.7% (283/400) were willing to screen/rescreen if provided with the opportunity. Majority of the study participants, 70.5% (282/400) had ever heard about prostate cancer, mostly from a health worker (40.8% (115/282)). Less than half of the participants had high knowledge of prostate cancer. The factors that were significantly associated with prostate cancer screening were age ≥ 70 years, Adjusted Odds Ratio (AOR) 3.29: 95% Confidence Interval (CI): 1.20-9.00) and having a family history of prostate cancer, AOR 2.48 (95%CI: 1.32–4.65). Conclusion There was low uptake of prostate cancer screening among men in Lira City, but majority of men were willing to screen. We encourage policymakers in Uganda to ensure prostate cancer screening services are readily available and accessible by men so as to improve on early identification and treatment of the disease.